THE EPIDEMIOLOGY OF PERIPHERAL FRACTURES

Although much is known about hip fracture epidemiology, there are rela tively little data regarding fractures at other peripheral sites. Epid emiological differences between fractures are important, since they im ply that an understanding of the consequences and clinical expression of osteoporosis requires the study of many different fracture types. R ecent data regarding the basic epidemiology of limb fractures among th e elderly in industrialized countries have made some patterns clear. F ractures outside the hip are relatively common events, and before age 70 to 75, ankle and distal forearm fractures occur more commonly than fractures of the hip. Among the elderly, fractures at the most proxima l and most distal ends of the limbs have the highest incidence. Thus, in the upper extremity, fractures of the proximal humerus and distal f orearm are the most common, while in the lower extremity, those at the hip and ankle predominate. Outside the axial skeleton, females have h igher rates for most fracture types, and at most fracture sites whites have higher rates than blacks. In each limb, the most proximal fractu res tend to have the most pronounced age-related increases in risk.